September 27 Veterans News

Officials: More than one-third of calls to VA suicide hotline are left unanswered (PBS Newshour)More than one-third of calls to a suicide hotline for troubled veterans are not being answered by front-line staffers because of poor work habits and other problems at the Department of Veterans Affairs, according to the hotline’s former director. Some hotline workers handle fewer than five calls per day and leave before their shifts end, even as crisis calls have increased sharply in recent years, said Greg Hughes, the former director of the VA’s Veterans Crisis Line. Hughes said in an internal email that some crisis line staffers “spend very little time on the phone or engaged in assigned productive activity.” Coverage at the crisis line suffers “because we have staff who routinely request to leave early,” he said. An average of 35 to 40 percent of crisis calls received in May rolled over to back-up centers where workers have less training to deal with veterans’ problems, Hughes said. Hughes left his post in June, weeks after sending the emails. The House is expected to vote Monday on a bill requiring the VA to ensure that all telephone calls, text messages and other communications received by the crisis line are answered in a timely manner by an appropriately qualified person. Rep. David Young, R-Iowa, the bill’s sponsor, said a veteran in his district told him he repeatedly received a busy signal when he called the crisis line this spring. The man later got help from a friend, but “this hotline let him down,” Young said. “A veteran in need cannot wait for help, and any incident where a veteran has trouble with the Veterans Crisis Line is simply unacceptable.” The VA said Monday it is increasing staff at the New York-based hotline and opening a new hub in Atlanta. The agency also pledged to continue efforts to improve training, as it responds to a report by an internal watchdog that said crisis calls are routinely allowed to go into voicemail and callers do not always receive immediate assistance. David Shulkin, the VA’s undersecretary for health, called veterans’ suicide a public health crisis and said suicide prevention is a top priority at VA. An estimated 20 veterans commit suicide every day; the vast majority were not connected to VA care in the last year of their lives, Shulkin said. The crisis line dispatched emergency responders an average of 30 times a day last year and made 80,000 referrals to suicide prevention coordinators, he said. “We are saving thousands of lives. But we will not rest as long as there are veterans who remain at risk,” Shulkin said in a statement. The House bill follows a February report by the VA’s office of inspector general indicating that about 1 in 6 calls are redirected to backup centers when the crisis line is overloaded. Calls went to voicemail at some backup centers, including at least one center where staffers apparently were unaware there was a voicemail system, the report said. The crisis hotline received more than 500,000 calls last year, 50 times the number it received in 2007, the hotline’s first year of operation.

Stronger protections for VA whistleblowers included in bill to keep government open (Stars and Stripes)A long-stalled plan in Congress to strengthen protections for Veterans Affairs Department employees who disclose waste and misconduct — and to punish officials who retaliate against them — is poised to hitch a ride to enactment this week on the high-priority measure to head off a partial government shutdown. Authority to continue funding the government beyond the end of its budget year Friday was attached to a spending bill for the VA that contains language to aid whistleblowers there. The Senate is set to take up that measure first and then the House – action needed to prevent a partial government shutdown because regular spending bills bogged down. While the measure would continue funding most government operations only through Dec. 9, the portions affecting the VA – along with military construction projects also funded by the same underlying bill – would apply through the entire new fiscal year. “VA has promised to foster a culture of openness by encouraging employees to report cases of wrongdoing, yet there continue to be reports that after bringing to light cases of wrongdoing, the whistleblowers become subjects of retaliation,” says a summary by the Senate Appropriations Committee. VA employees mainly disclosed the manipulation of patient scheduling wait times and other management issues that have embroiled the department in controversy over the past two years. One side effect was a wave of complaints from those employees, and from those who cooperated with investigations, about reprisal by management. The measure requires supervisors to promptly investigate disclosures made by their subordinates and to disclose what actions they will take if there seems to be a genuine problem; gives employees the right to pursue the issue with higher-level management if dissatisfied with the response; and creates a new central office “to ensure whistleblower disclosures receive the prompt, impartial attention deserved.” Management officials who retaliate against whistleblowers – for example, by lowering their job ratings or shifting them to make-work duties – would be subject to mandatory discipline: for a first offense, between a 12-day suspension and firing; a second offense, firing. That would be a rare departure from the general government policy of allowing agencies to choose what, if any, discipline to impose. Further, job ratings of supervisors would include how they responded to whistleblower complaints. Similar language is in several other bills that have been pending for months in Congress, including one recently passed by the House and sent to the Senate. That bill also includes several restrictions on VA employee rights to appeal disciplinary actions up to and including firing. While the White House objected to the appeal rights changes in that bill, it did not threaten a veto, nor oppose the whistleblower provisions. Changes in personnel practices at the VA, whose 330,000-plus employees make up about a sixth of the federal workforce outside the independent Postal Service, are widely seen as setting a precedent for a bid to make the same changes throughout the government.

The ‘invisible’ woman: She just may be a veteran (Military.com)Strong, resilient, capable — and sometimes invisible. Those are some of the ways women military veterans see themselves, according to those who gathered Saturday in Tacoma for the 2016 Women Veterans Summit. The event, sponsored by the state Women Veterans Advisory Committee, the state Department of Veterans Affairs and others, drew women from around the state. They came to learn about veterans’ benefits, staying healthy — physically and mentally — and more. But many said they came to connect to the unique sense of family that binds military women of all ages. “We come from different branches of the military, but we all have the same goal,” said Louretha Glasl, an Army veteran from Yelm who was wearing a red T-shirt that identified her as part of the “sisterhood of proud women veterans.” Glasl, who grew up in Cleveland, Ohio, joined the Army six months after graduating from high school. She spent 14 years in the Army working several jobs, including refueling combat vehicles and aircraft during Desert Storm in the 1990s. She’s spent an equal number of years as a civilian and now works for the state Veterans Department. Asked what she wants people to know about women veterans, she replied: “We are strong, capable, intelligent — and we can lead.” Keynote speaker Kayla Williams is an example. A former military Arabic language expert who spent five years in the Army, she now heads the Center for Women Veterans, part of the Veterans Administration. She spoke of her participation in the 2003 U.S. invasion of Iraq, where she served as an interpreter. Her memoir from that experience, “Love My Rifle More Than You: Young and Female in the U.S. Army,” was published in 2005. Williams, who left the Army that year, also talked about what is was like for women veterans upon their return home from Iraq. While both men and women sometimes felt that the country as a whole had forgotten about the ongoing war, Williams said that as a woman veteran she sometimes felt “isolated, unrecognized.” In social gatherings, she added, people might spot a group of military personnel and offer to buy “the guys” a beer. But they assumed the women at the table were wives or girlfriends. Someone once asked if her three-legged German shepherd, who had lost a leg after being hit by a car, had been injured in combat. She realized that civilians might be more ready to assume her pet was a veteran, rather than asking if she had served her country. Williams met her husband, Brian McGough, in Iraq. But they didn’t have time to do much dating there. They married in 2005, two years after McGough sustained a brain injury from an explosion that rocked a military convoy he was riding in. Williams told veterans who gathered Saturday that there is help available for those who are also struggling with the aftermath of war and other problems — including care needed as the result of sexual trauma. She also reminded them that spending time with other veterans is one way to heal. “I share a bond with all those who have gone to war before me,” Williams said. “Rather than being isolated, I am part of a community. You are not alone.” Jean “Bell” Belmont, who attended Saturday’s event, served 22 years in the Army and is part of the Suquamish Warriors, a group of Native American veterans who attend military funerals and other public events. She regularly wears a hat and vest that display emblems of both her military and Native pride, as well as her ties to other women who served. “For the female veterans, it’s been a long haul in the military,” Belmont said, “trying to make it through the military in a man’s position.”

Report: Vets in prison received $100M in improper benefits payouts (MilitaryTimes)
Imprisoned veterans received more than $100 million in improper benefits payments in recent years because Veterans Affairs officials were too focused on bringing down the first-time claims backlog, according to a new report from the department’s inspector general. And that number could rise to more than $200 million in the next four years if changes aren’t made in how VA monitors and handles the problem. Officials from the Veterans Benefits Administration said the problem lies with incomplete information from the Bureau of Prisons. Beth Murphy, director of VBA’s compensation service, said her department is working on fixes. “We do not get the date of incarceration from (the Bureau of Prisons),” she told members of the House Veterans’ Affairs Committee on Tuesday. “We have to follow up on this. There are manual processes and time lags in getting this information.” By law, veterans jailed for more than 60 days are eligible only for compensation benefits equal to a 10 percent disability rating (for those already at 10 percent, it drops to 5 percent). Once veterans are released, they are eligible for their full benefits again. But investigators estimate almost $60 million in overpayments to veterans in federal prisons from fiscal 2008 to fiscal 2015, and another $44 million to veterans in state and local jails in 2013 and 2014. “We found that VBA did not process federal incarceration adjustments primarily because they did not place priority on incarceration adjustments, as they do not consider these non-rating claims part of the disability claims backlog,” said Mike Missal, the VA inspector general. Reducing that backlog has been a major focus of the department in recent years, with the number of cases taking four months to process ballooning to around 611,000 in 2013. Today, that number is around 75,000 cases. Murphy said part of that effort has been automating more VA systems and outside data, and officials hope to use those advances to correct the prison payouts problem moving forward. Lawmakers called the findings unsettling. “The veterans who received these overpayments have committed crimes, but the overpayments are not their fault,” said Rep. Ralph Abraham, R-La., chairman of the panel’s subcommittee on disability assistance. “Nothing excuses VA for failing to do its job.” Veterans sent to prison are required by law to inform VA of their legal status, but both lawmakers and VA officials acknowledged that is a less-than-reliable system. VA Inspector General reports have estimated total improper payments for all veterans benefits programs totaled more than $1.3 billion in fiscal 2015, with the prison issue a small segment of that. Murphy said incarcerated veterans make up less than 1 percent of the overall population of individuals receiving VA benefits. Still, she conceded that the mistakes amount to a significant amount of lost taxpayer funds, and promised her agency will find solutions. Officials are working to recover some of those improper payments. “We are focused on this now,” she said. “Going forward, I will be watching this.”

Veteran groups intervene in fired Phoenix VA director lawsuit (Stars and Stripes)A dozen veteran and military groups have entered the legal fight with former Department of Veterans Affairs executive Sharon Helman in hopes they can salvage a law allowing the department to fire top managers more quickly. A federal appeals court this month allowed the Veterans of Foreign Wars, AMVETS, Iraq and Afghanistan Veterans of America and nine other groups to join the lawsuit between Helman and the VA. They argue the law used to fire her is constitutional and should be upheld. The outcome will determine the future of the 2014 law that allows executives to be terminated in three weeks with no option for an appeal and was part of an effort by Congress to root out a “corrosive” management culture after the VA’s national wait-time scandal. The VA announced it would abandoned the law in June — potentially handing Helman a win in court — because the Justice Department decided it violated the rights of the roughly 300 executives employed by the sprawling department. “This ruling is an important win for us,” the attorney for the veteran and military groups, Michael Morley, wrote in an email to Stars and Stripes. “Most basically, it shows that the court takes our arguments seriously and will not invalidate the [law] without considering them.” If the groups prevail, the VA could continue to expedite its firings of executives guilty of wrongdoing, which supporters including veterans groups hope will help fix the troubled department. Otherwise, Helman could win her lawsuit and the VA will return to the previous firing guidelines used for all federal executives. Morley, when reached by phone Monday, said the court has allowed the groups’ argument that the streamlined firings are constitutional to be added into the lawsuit. Now, Helman and the VA will likely file responses with the U.S. Court of Appeals for the Federal Circuit in the coming weeks and there could be oral arguments heard in December or January, he said. The lawsuit also includes the National Association for Uniformed Services, Reserve Officers Association, Non-Commissioned Officers Association, Marine Corps League, Army Reserve Association, Marine Corps Reserve Association, U.S. Army Warrant Officers Association, Special Forces Association and Jewish War Veterans of the United States. The lawsuit also includes the National Association for Uniformed Services, Reserve Officers Association, Non-Commissioned Officers Association, Marine Corps League, Army Reserve Association, Marine Corps Reserve Association, U.S. Army Warrant Officers Association, Special Forces Association and Jewish War Veterans of the United States. Helman is suing the VA over her firing in 2014 when she was director of its Phoenix hospital system. A whistleblowing doctor triggered a national scandal with claims that veterans in Phoenix had died while waiting for care. Federal audits found secret wait lists were kept there and at VA health care facilities across the country to hide long delays. Helman was ultimately fired for accepting thousands of dollars in gifts that included a paid trip to a Disney theme park and concert tickets. An appeals judge found in December 2014 that the VA did not have grounds to fire Helman for the wait-time issues. But the law used to fire her quickly has been at the center of the case. In the wake of the 2014 scandal, Congress passed the new rule streamlining the firing of executives implicated in wrongdoing. It allowed an administrative judge to make a final decision on a termination appeal within 21 days and included no option for a further appeal. Like other federal executives, VA managers had been able to appeal their termination to the Merit Systems Protection Board in a process that could typically take months. Concerns over the legality of the quick firings bubbled up even before the law was passed and the VA later told Congress it had misgivings. The firing rule suffered a major blow in May when the Justice Department said denying any appeal after an administrative judge’s decision violates executives’ due process rights and is unconstitutional. The VA followed in June with the announcement that it would no longer firing executives using the expedited rules.

Deaths and complications after surgery decline at VA hospitals (Fox News)Surgery patients in Veterans Affairs (VA) hospitals are much less likely to die or suffer postoperative complications today than they were 15 years ago, a U.S. study suggests. Researchers examined data on more than 700,000 mostly male patients who had surgery at 143 VA hospitals nationwide from 1999 through 2014. The proportion of patients who had major complications dropped from 10 percent to 7 percent during the study period. Among patients who did have major complications, the proportion that died as a result declined from 24 percent to 15 percent. “Our data in many ways mirror trends that we find in the private sector as well,” said lead study author Dr. Nader Massarweh, a researcher at Baylor College of Medicine and the Michael E. DeBakey VA Medical Center in Houston. “Some of what we are seeing is probably the end result of underlying trends that have been occurring over time across all of healthcare relating to our ability to simply provide better care,” Massarweh added by email. At the VA in particular, surgical care may have also improved as a result of a quality initiative started in the 1990s to track surgical outcomes, identify problems and evaluate fixes, Massarweh said. One focus of this effort was to minimize the potential for patients to die after complications develop following surgery, a situation known in the healthcare industry as “failure to rescue.” This might happen, for example, when a patient undergoes a colon operation, develops pneumonia after surgery, ends up in the intensive care unit on a ventilator and then dies, Massarweh said. “Our goal is to minimize the number of patients who experience complications and in those who do to treat them as quickly and definitively as possible,” Massarweh said. “This is one of the reasons failure to rescue has gained traction as measure of quality – it acknowledges that complications do occur, but that timely recognition and treatment are really the things we can control to minimize their impact on patients.” To assess how quality improvement efforts have influenced surgical outcomes at the VA, researchers analyzed data on patients having inpatient surgery or operations for vascular, spinal, orthopedic, neurological, thoracic, genital or urinary issues. They excluded cardiac surgeries from the analysis. Overall, patients were about 64 years old on average and 96 percent were men. During the entire study period, almost 98,000 patients (14 percent) had complications after surgery, and failure to rescue occurred for about 13,000 of them. Roughly 67,000 patients (9.5 percent) had major complications during the study, and failure to rescue happened in about 12,000 cases. The odds of postoperative death or failure to rescue were about 40 to 50 percent lower by the end of the study than at the start, researchers report in JAMA Surgery. Researchers received funding for the study from the VA. Limitations of the study include the lack of a comparison group of hospitals that didn’t implement the VA’s quality control initiative because it was done systemwide, the authors note. The findings also don’t prove what caused any improvements in outcomes. Researchers also lacked data on surgical volume, which can influence the outcome of quality improvement efforts because surgeons are thought to be better at procedures they do more frequently, the authors note. The study doesn’t examine access to care issues including long waits for appointments that have been raised at the VA in recent years.

For those with the often solitary task of caring for disabled vets, help is on the way (MilitaryTimes)
Spouses, parents, family and friends who care for disabled troops or veterans soon will have a new resource to lean on for support, inspiration and confidence when they need it. The Military and Veteran Caregiver Network is training experienced caregivers to serve as mentors for those new to the role or who think they could benefit from a relationship with a seasoned caregiver. The idea is develop a group trained to provide insight, knowledge and skills to those who need assistance. Through the network, caregivers seeking a mentor will be electronically matched to one with a similar experience or background. “The isolation caregivers of all eras feel is very, very real,” said Lynda Davis, MCVN executive director. “It’s valuable to have a place to go, a person to turn to, just to know you are not alone.” According to a report published by Rand Corp. in 2014, more than 22.6 million people in the U.S. care for a person who faces challenges functioning independently, including 5.5 million caring for veterans. More than 1 million Americans are providing care and support for ill or injured Iraq and Afghanistan veterans, according to Rand. Davis said more than half of caregivers are isolated with no social interaction. MCVN is designed to reduce isolation, increase connections and provide caregivers the tools they need to help their loved ones. “We are run by and for caregivers,” Davis said. “We partner with over 200 organizations and have the real ability to help.” The MVCN’s new Peer Mentor Support Program will provide eight hours of training to would-be mentors, including four hours of self-paced classes and four hours of group training. The goal is to relieve stress and provide further support to caregivers in the network, which has 100,000 connections through a variety of social media sites and outreach, Davis said. The program will be formally introduced in Washington D.C. during a week that includes several events dedicated to the military caregiver cause. On Tuesday, the Elizabeth Dole Foundation, a nonprofit focused on supporting military caregivers, will host a Hidden Heroes campaign summit to call attention to the needs of military and veterans caregivers. Hidden Heroes will serve to “awaken the nation to the service and sacrifice of America’s military and veteran caregivers, according to organizers. Those scheduled to participate in the event include former North Carolina Sen. Elizabeth Dole, actor Tom Hanks, honorary campaign co-chairman Sen. Thom Tillis, R-N.C., House Minority Leader Rep. Nancy Pelosi, D-Calif., and Veterans Affairs Secretary Robert McDonald. McDonald is to discuss improvements in VA programs to assist those who care for veteran patients. The following day, the VA will host a day long event to strategize on the long-term challenges of caregivers. The National Academies of Sciences, Engineering and Medicine issued a report on Sept. 13 calling for more support of the nation’s caregivers, particularly their own health and financial needs. The report noted that the health care delivery system must better account for the roles of family caregivers, given that the number of family caregivers will shrink in the coming years as demand rises. “Ignoring family caregivers leaves them unprepared for the tasks they are expected to perform, carrying significant economic and personal burdens,” said Richard Schulz, a psychiatry professor at the University of Pittsburgh. “Caregivers are potentially at increased risk for adverse effects in virtually every aspect of their lives — from their health and quality of life to their relationships and economic security. If the needs of the caregivers are not addressed, we as a society are compromising the well-being of elders. Supporting family caregivers should be an integral part of the nation’s collective responsibility for caring for its older adult population.” The MCVN began as a loose network of caregivers using social platforms like Facebook. Davis said as the social network grew, organizers realized there was a need for a secure social network where members could share confidential information and get assistance from others. Bristol-Myers Squibb provided the seed money to establish the network, which is housed by the Tragedy Assistance Program for Survivors. “We created this because there wasn’t a safe formal platform to share sometimes very sensitive information,” Davis said. “We have grown to more than 100,000 contacts and continue to grow.”

Whistleblower: Bodies of unclaimed vets languish at Hines VA Hospital (CBS Chicago)The bodies of military veterans lay unclaimed for weeks at a time at the Hines VA Hospital, a whistleblower alleges. Staff from the U.S. Department of Veterans Affairs in Washington are in town looking into that complaint. … When 68-year-old Marine veteran George Taylor died, no family or friends claimed him. Earlier this month, Jackie Gluekert and her funeral home made sure the hero got a dignified send-off — a burial in an a national cemetery. “It is a final salute, and I’m proud to do it,” Jackie Glueckert says. A whistle-blower inside the Edward Hines Jr. VA Hospital says unclaimed vets aren’t getting the proper goodbye they deserve. Internal emails obtained by CBS 2 reveal at least two unclaimed vets sat inside the morgue for at least 30 days this summer, allowing the bodies to badly decompose. U.S. Sen. Mark Kirk of Illinois complained to the VA secretary and even introduced new legislation. “The VA should be sickened and embarrassed by yet another exposed case of corruption and mistreatment of our veterans at Hines,” Kirk says. “I have personally called Secretary McDonald and asked him to fire Christopher Wirtjes, the Chief responsible for this shameful treatment of our veterans’ remains. Bureaucrats at Hines should spend as much time helping veterans as they do covering up neglect and abuse.” Last year, Wirtjes was put on leave for ordering staff to manipulate waiting times but has since been reinstated. The VA said an investigation continues but signaled it has not uncovered any widespread problem. “We take whistleblower allegations very seriously and absolutely agree that all of our veterans deserve dignity and respect, in life and in death. While our investigation into this matter is still ongoing, we have found allegations related to consistent problems with dignified and timely burials to be unsubstantiated. However, we have taken this opportunity to review our policies and procedures and are currently working to improve them,” a spokesperson said. When a veteran dies at the VA hospital and goes unclaimed, arrangements are supposed to be made with an outside funeral home. For whatever reason, this whistle-blower says, that is simply not happening in a timely fashion.

Governor of South Carolina creates veterans policy committee (Stars and Stripes)South Carolina Gov. Nikki Haley issued an executive order Monday creating the Veterans Policy Advisory Committee. The committee will assess the needs of the state’s more than 400,000 veterans, including the employment and mental health challenges some face as they transition to civilian life. Made up of veterans, state lawmakers and representatives of various state agencies, the panel will recommend policy changes to the S.C. Military Base Task Force and the governor. “There is no better way to thank our brave men and women in uniform than by taking care of them when their time of service ends,” Haley said in a news release. State Rep. James Smith, a Richland Democrat and combat veteran, thanked Haley for creating the panel. “It’s critically important that we maintain our focus on meeting the needs of veterans and their families,” he said. S.C. Adjutant General Bob Livingston said of the state’s veterans: “While they have already earned our support and gratitude, we must provide them with avenues to contribute to our communities and state. Where there are obstacles, we need to remove those obstacles and where there are opportunities, we need to build on those opportunities.”